Healthcare Provider Details

I. General information

NPI: 1477240745
Provider Name (Legal Business Name): SUCCESS STAFFING AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 A OLD DERBY ROAD
NORWOOD MA
02062-1771
US

IV. Provider business mailing address

609 A OLD DERBY ROAD
NORWOOD MA
02062-1771
US

V. Phone/Fax

Practice location:
  • Phone: 617-749-6194
  • Fax:
Mailing address:
  • Phone: 617-749-6194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code282J00000X
TaxonomyReligious Nonmedical Health Care Institution
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL

VIII. Authorized Official

Name: SANDRA WILSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: CEO
Phone: 617-749-6194